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An observational study evaluating tacrolimus dose, exposure, and medication adherence after conversion from twice- to once-daily tacrolimus in liver and kidney transplant recipients
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
2014 (English)In: Annals of Transplantation, ISSN 1425-9524, Vol. 19, 138-144 p.Article in journal (Refereed) Published
Abstract [en]

Background: Immunosuppression regimens in transplantation medicine are complex. Drugs with extended release action have simplified medication dosing without affecting efficacy. Material/Methods: This prospective, observational, multicenter study, conducted in a routine medical practice setting, evaluated changes in tacrolimus daily dose and trough levels and patient-reported medication adherence at day 90 after 1:1 ( mg: mg) conversion to once-daily tacrolimus in adult liver and kidney transplant recipients. Results: Data from 224 recipients of a liver (n=19) or kidney (n=205) transplant, average age 51 +/- 14.5 years, were evaluated. The mean change in tacrolimus daily dose was +0.04 mg/day. Dose remained stable after conversion in 62.5%,was lower in 15.6%, and higher in 22% of patients. Trough level after conversion was lower in 62.6% and higher in 36.5%; generally, levels were 12.8% lower than pre-conversion levels. No acute rejection, graft loss, or serious safety events were observed. Two deaths occurred due to myocardial infarction. Conversion helped 19% to less frequently forget medications and 55% reported no difference in remembering to take the once-daily dose after conversion. The change in dosing frequency was identified as '' better" for 55%. Conclusions: Tacrolimus daily dose remained stable while trough levels were significantly lower after conversion to once-daily dosing. Safety and efficacy were maintained; reduced dosing frequency had no apparent influence on patient-reported medication adherence.

Place, publisher, year, edition, pages
2014. Vol. 19, 138-144 p.
Keyword [en]
medication adherence, once-daily tacrolimus, tacrolimus exposure, organ transplantation
National Category
URN: urn:nbn:se:uu:diva-236105ISI: 000342974400001OAI: oai:DiVA.org:uu-236105DiVA: diva2:762753
Available from: 2014-11-12 Created: 2014-11-12 Last updated: 2014-11-12Bibliographically approved

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Bäckman, Lars
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Transplantation Surgery
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